The Power of Sleep

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77% of American adults haven’t been sleeping as well since the start of the COVID-19 pandemic

The Scourge Of Sleeplessness

We spend one-third of our lives either sleeping or attempting to sleep

Who Is Getting Enough Sleep?
- Before the pandemic, most Americans were getting enough sleep
  - 65% Employed
  - 60% Unemployed
  - 51% Those Unable to Work
- With the unemployment at an all time high, and the added stress of a pandemic, sleep problems are more rampant than ever before
  - How will Americans use their extra time at home?
    - 11% getting more sleep
    - 37% watching Netflix
    - 32% exercising
    - 20% playing video games

At least 6 of the 10 leading causes of death* have been linked to lack of sleep

Sleep & Immunity

What Is Immunity?
- Active Immunity: Exposing the body to an antigen to generate a long term adaptive immune response
  - Created by vaccination or recovering from infection with diseases such as chicken pox
- Passive Immunity: Providing antibodies from another source to provide immediate, short term protection
  - Transferring antibodies from mother to infant or through plasma from recovered patients

Before COVID-19, the 4 coronaviruses known to cause common cold granted recovered patients only passive immunity, lasting a few months or years — Likely the reason people get colds so often

Innate Immunity: The body’s ability to defend against pathogens, even without active or passive immunity
- Include natural defenses like coughing, tears, skin, hair, mucus, and stomach acid
How Does Sleep Impact Immunity?
- Cytokines: Proteins produced and released during sleep that regulate both innate and adaptive immune systems
  - Lack of sleep reduces the immune responses that target infection and inflammation
- White Blood Cells: A group of blood cells that fight infection, control immune response, and create antibodies
  - During sleep, white blood cells accumulate and fight off antigens trapped by lymphatic tissues
- Cortisol: Known as “the stress hormone”, reduces inflammatory response and triggers lower cytokine production
  - By acting as an anti-inflammatory, cortisol may improve immune function in short bursts — But chronically high-stress has the opposite effect
The Sleep/Stress Cycle
- Cortisol and melatonin regulate sleep/wake cycles
  - Morning:
    - High cortisol levels
    - Low melatonin levels
    - Higher blood pressure
    - Lower inflammation
    - Feeling awake and alert
  - Evening:
    - Low cortisol levels
    - High melatonin levels
    - Lower blood pressure
    - Higher immune response
    - Feeling tired and drowsy
- Too much stress raises cortisol levels, leading to
  - Sleep problems and fatigue
  - Issues with memory and focus
  - Poor immune function

In 2020, Americans will spend $52 billion on sleep aids and remedies — up from $41 billion in 2015

How To Get Better Sleep

Tips For Healthy Sleep
- Be Consistent:
  - Stick to a sleep schedule, even on weekends
  - Create a calming bedtime routine
  - Avoid evening snacks and caffeine after noon
- Manage Light:
  - Eliminate as much light as possible in your bedroom
  - Avoid screens for at least 1 hour before bed
  - Use bright morning light to feel more awake and alert
- Make It Comfy:
  - Keep your bedroom cool — Ideally between 60 and 67℉
  - Eliminate distracting noises with ear plugs or white noise
  - Ensure your mattress and pillows are supportive and allergen free
Still Can’t Sleep?
- Beware Of Naps: Napping may help you feel more rested during the day, but can make it harder to sleep at night
- Watch Your Intake: Substances like caffeine, alcohol, nicotine, and even spicy foods can interfere with sleep
- Do Something Else: If you can’t fall asleep, go into another room and do something relaxing, then try again

Talk To A Doctor about any ongoing sleep problems

Sleep & COVID-19
- 70% of American adults think lack of sleep increases their susceptibility to COVID-19
  - 48% say anxiety about the pandemic has led to trouble sleeping
- Since the start of the pandemic, people around the world are reporting more vivid, odd, or memorable dreams
  - Research has shown
    - High stress and anxiety increases negative content in dreams
    - Dreams following traumatic events may be more intense and memorable
    - Social isolation leads to more dreams featuring friends and family
  - While dreams don’t affect the quality of your sleep it can be hard to fall asleep after waking from a nightmare — and bad dreams can have a “hangover” effect that carries into your next day
- What habits help you sleep better?
  - Avoiding news about COVID-19: 46%
  - Spending evenings reading: 40%
  - Taking sleep supplements: 27%
  - Practicing meditation or yoga: 21%
- 23% of Americans say stay-at-home has eroded their sleep schedule
  - 58% sleep more
  - 19% sleep less
How Much Sleep Is Enough?
- “You need as much sleep as it takes for you to stay awake and alert the next day, without caffeine” — Dr. Nathaniel Watson, President of the American Academy of Sleep Medicine
- For most people, that’s at least 7 hours of sleep each night